Insurance wastes time and lives

Posted
Friday, June 8, 2018 12:05 am

To the editor:

As part of the ongoing discussion on health care policy, it has been noted that health insurance today wastes time, resources — and lives. It costs us far more than simply dollars for premiums and deductibles, and creates harm.

Here is how that applies to an issue much in the news today — the opioid crisis.

I recently retired after 30 years of service with the state Office of Alcoholism and Substance Abuse Services, the last 12 of those serving as director of downstate field operations, overseeing funding, program deliverables, regulatory compliance, and service development for New York City and Long Island.

In that role, I oversaw the work of more than 200 provider agencies, large and small, and was responsible for more than $200 million in state aid funding.

Since my retirement, I have been working as a behavioral health care consultant, assisting provider agencies with their program development and financial models.

In a world of finite resources, dealing with insurers robs time, effort and resources from direct care, for those in need, even in a state that has some of the most favorable laws regarding insurance and substance use disorders. Over my years in this field, provider agencies, and their executive directors, fiscal officers, medical staff, counselors and support staff, as well as consumers, their families and loved ones, have repeatedly raised the same concerns.

Chief among them: The amount of time, effort and resources expended on dealing with insurers and their armies of claims representatives, utilization review specialists, authorization specialists and so on.

For the current opioid epidemic that has struck virtually every community in this area so hard, requiring so much effort denies care to those in need.

Behavioral health services (especially for those with co-occurring disorders) and physical health services spend too much previous staff time dealing with insurers so the lights can be kept on and the staff paid. It is a system best described by an analogy of “The Godfather, Part II,” where young Vito Corleone’s nemesis, Dan Fanucci, repeats his mantra, “I just want to wet my beak.”

In addiction care, however, each beak-wetting means one less individual or group counseling session, one less family meeting, one less dose of life-saving addiction medication.

There are many reasons to support the New York Health Act. In my decades of experience, one stands out: Insurers divert too many resources from direct care. The current cost of dealing with convoluted mandates of private insurance should be measured not just in time and dollars expended, but in lives wasted and lost.

No less important, the New York Health Act will augment focus on the fight against opioid use disorders and addiction rather than defuse resources and effort.

To learn more, visit NYHCampaign.org, and then urge your legislators in Albany to support this essential bill.